As a Doctor Tried to Take Lives, Others Rushed to Save Them

As fire alarms blared and smoke billowed from the 16th floor of Bronx-Lebanon Hospital Center where a gunman had set himself ablaze after shooting seven people on Friday, hospital workers rushed the injured to the emergency room and got to work.

On the battlefield, medics refer to the golden hour, the initial 60-minute window that is crucial for getting trauma victims into treatment. Even more significant is the platinum ten, the first critical minutes that can mean the difference between life and death.

The quick care given to those wounded by the gunman, identified by a police official as Dr. Henry Bello, who had worked at the hospital, may prove to be the most important factor in whether they survive. A doctor was killed in the shooting before Dr. Bello killed himself.

Beyond the rush to treat the victims, other doctors and hospital staff members sought to comfort patients and continue to provide care for more than an hour while the hospital was locked down.

Evelyn Torres-Ferrara, an administrative employee at the hospital who had just been discharged after surgery to have a tumor removed from her face, was on the eighth floor with her husband when the shooting occurred.

Ms. Torres-Ferrara said the couple had not heard gunfire or seen those who were hit, but had watched doctors rushing to stabilize what a co-worker told her were two victims, one who had been shot in the leg and the other who been struck in the neck.

She said the victims had been quickly taken to the first-floor emergency room.

“It definitely helped that the doctors were right there,” she said.

Her husband, Ian Wittenberg, a pediatrician who has worked at Bronx-Lebanon for 17 years, said there were tough challenges ahead.

“A gunshot wound to the neck, there are so many large blood vessels there,” he said. “No one is safe from that.”

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Employees at Bronx-Lebanon Hospital Center on Friday amid a lockdown put in place after a gunman entered the building.CreditJulio Cortez/Associated Press

Dealing with a gunman intent on inflicting mass casualties in a hospital presents unique challenges. Unlike in a school or a movie theater, many of the people in a hospital are patients who cannot be moved.

The instinct when gunshots are fired is to run. If you are in an operating room, that is not an option.

“You really have to depend upon the judgment of people in these situations” he said.

Hospitals conduct robust training for lockdown situations and have stringent protocols for protecting staff members and patients.

“The specific security staff at a hospital will not be armed and not able to do much about a random shooting like this,” Dr. Redlener said.

Many such drills focus on what is considered the most likely shooting scenario in a hospital — a gunman entering through the emergency entrance — but if a disgruntled employee or former patient familiar with the building’s layout is involved, the threat could be more problematic.

Kyrillos Rezkalla, a third-year medical student, was on the hospital’s ninth floor at the time of the shooting. He said he had barricaded himself and others in a conference room after watching several doctors rush toward a stairwell.

The words “code silver” — the term for “person with a weapon” — came over the speakers. The “coat team,” as Mr. Rezkalla called the doctors, rolled a stretcher and carried gauze.

They were responding to a gunshot wound, which Mr. Rezkalla said he had heard was to the victim’s liver. The doctors needed to attend to the patient’s immediate needs before taking him to the emergency room.

“The people who ran out there were really courageous,” Mr. Rezkalla said. “It’s a big risk that they took, but they did it.”

Correction:

Because of an editing error, an earlier version of this article included an incorrect credit with a picture of people who had been evacuated from Bronx-Lebanon Hospital Center. The photographer was Jeenah Moon for The New York Times, not David Dee Delgado for The New York Times.

Annie Correal contributed reporting.

A version of this article appears in print on , on Page A19 of the New York edition with the headline: Scrambling to Save Lives As a Place Built for That Turns Into a Battlefield. Order Reprints | Today’s Paper | Subscribe